Individual ProviderTaylor GravesNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1649 Ky-192 W, London, KY 40741(606) 330-0055PECOS EnrollmentBased on the most recent information from CMS, provider Taylor Graves is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1376134395Provider TypeIndividualFull NameGraves, TaylorGenderFemaleSole ProprietorNoEnumeration Date2/2/2021Last Updated2/2/2021Contact InformationPractice LocationPractice Address1649 Ky-192 W, London, KY 40741Phone(606) 330-0055FaxUnlisted FaxMailing LocationMailing Address1649 Ky-192 W, London, KY 40741Phone(606) 330-0055FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense3015338Kentucky